Rapid assays for T-cell activation by RNA measurements using flow cytometry

ABSTRACT

The present invention relates to a method for rapidly detecting copies of at least one RNA molecule expressed in individual cells and uses thereof.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a U.S. National Phase of International ApplicationNo. PCT/US2013/047774, filed Jun. 26, 2013, which claims priority ofU.S. Provisional Application No. 61/665,231 filed Jun. 27, 2012 and U.S.Provisional Application No. 61/784,802 filed Mar. 14, 2013. The contentsof the applications are incorporated herein by reference in theirentirety.

GOVERNMENT INTERESTS

The invention disclosed herein was made at least in part with Governmentsupport under Grant Nos. AI045761, AI106036, MH079197, and HL106788 fromthe National Institutes of Health. The United States government hascertain rights in the invention.

FIELD OF THE INVENTION

This invention relates to methods that rapidly detect gene expression inindividual cells.

BACKGROUND

Many pathological conditions provoke T cell-mediated immune responses.These include cancer, autoimmunity, transplantation, and infectiousdiseases, including, for example, tuberculosis (TB). In all theseconditions, activation of T cells involving interaction of a T cellreceptor (TCR) with a specific antigen (Ag) as a common denominator,while the functional consequences of this interaction vary. In any givenT cell, the TCR signaling cascade may stimulate expression of differentsets of genes depending on the physical nature of the Ag, itspresentation, the TCR repertoire, and the strength of Ag-inducedactivation. These induced differences in gene expression patterns duringcell activation, proliferation and differentiation may ultimatelycontribute to functional heterogeneity among the clonally expandedeffector cells. An additional element of cell-to-cell diversity arisesduring T-cell homeostasis. When the Ag is cleared, most expandedeffector cells die by apoptosis, while a small fraction of cells surviveas long-lived memory cells. The responses that occur upon re-exposure toAg are governed by the factors listed above, and are further influencedby the prior differentiation process. As a result, for each Agencountered, the immune response generates functionally distinct subsetsof T cells (for example, effector vs. central memory vs. effector memorycells) sharing the same Ag specificity. At any given time in the naturalhistory of an immunopathological condition, the relative representationof these different subsets varies; they may determine or reflect thedisease process. T-cell subsets correlate with Ag and pathogen load invivo and, as exemplified by studies of chronic viral infections and TB,quantitative analysis of these key subsets is promising for diagnosticsand measurements of protective immunity. Tell-tale changes in T cellsubsets should also be seen during treatment, since treatment outcome isassociated with a particular evolution of the immunopathologicalcondition. Such signatures of evolving states (natural ortreatment-mediated) escape ensemble measurements and can only bedetected at the single T cell level. The properties of individual Tcells are only fully revealed by their response to Ag stimulation.

Current, blood-based clinical immunoassays can typically recognize thepresence of non-infectious and infectious pathology, but may not revealprogression of the pathology. In contrast, single-cell, functionalanalysis of Ag-specific immune cells in peripheral blood should unravelmultiple, intersecting immunopathological states associated withevolution of infection and disease. Such analysis would help advanceprognostic capability and foster effective intervention. A compellingexample is provided by infection with Mycobacterium tuberculosis. Withcurrent methods, TB is typically diagnosed after the diseased subjecthas already transmitted infection to his/her contacts. Yet diagnosis ofasymptomatic infection per se does not warrant medical intervention. Theability to distinguish stable latent infection (LTBI) from early activedisease (before it is contagious) is greatly needed. Existingimmunodiagnostic assays fail to address this need, as they are notgeared to distinguish between Ag-specific, functional T cell subsetsknown to differ between infection states. Moreover, these assays do notassess responses that may reflect stage-specific expression ofmycobacterial Ags.

The hallmark of M. tuberculosis infection is the huge number of peopleinfected asymptomatically with this pathogen (2 billion). In the absenceof immunocompromise, 90-95% of latently infected individuals will notdevelop active TB. However, given the size of the reservoir, M.tuberculosis infection still causes 9.4 million new cases of active TBand 1.7 million deaths per year. Transmission of infection would begreatly reduced if it were possible to identify and treat infectedindividuals as they progress to active disease before they becomesymptomatic and infectious. Detecting tubercle bacilli or bacillaryproducts is exceedingly difficult during early active disease, due tovery low bacillary numbers. The standard, microbiological diagnosis ofactive TB detects individuals who already bear tubercle bacilli in theirrespiratory secretion and are therefore infectious.

Methods based on ensemble measurements are simply not geared torevealing the complexity of the cell-mediated immune response and cannotreveal rare or transient cell states associated with disease stage andevolution. The most common immunoassay formats for single T cellanalysis are the enzyme-linked immunospot assay (ELISPOT) method andquantitative flow cytometric (FC) analysis. In a commercial ELISPOT testfrom Oxford Immunotech (United Kingdom), peripheral blood mononuclearcells (PBMCs) are first isolated from a blood sample, washed andcounted. Then a predetermined number (such as 250,000) of PBMCs and M.tuberculosis-specific Ags are added to plate wells pre-coated withantibodies to interferon gamma (IFNγ) and incubated overnight (16-20hours). IFNγ released from activated T cells is captured in the wells.This is followed by incubation with a second antibody (Ab) conjugated toa color-forming enzyme, after which the wells are washed and acolor-forming substrate is added. Spots are produced where IFNγ wassecreted by T cells giving a characteristic appearance of a colored ringsurrounding the cytokine-releasing cell. Finally, spots are counted,either by naked eye or using a plate reader. ELISPOT is highly sensitive(its detection limit is 10/10⁶ in PBMCs). However, it fails to providethe desired discrimination among functional T cell subsets for severalreasons. First, it is not typically amenable to simultaneous detectionof several targets. Second, the format limits the number of cells foranalysis (e.g., 250,000 cells per well in the commercial T-SPOT.TB testmentioned above). Conventional FC has multi-parameter capability. Cellsin whole blood or PBMCs are stimulated by incubation for 6 hours or morewith specific Ags, for example M tuberculosis-specific peptides orproteins, and extracellular secretion inhibitor such as brefeldin ormonensin. Permeabilized T cells are then stained with fluorophor-labeledanti-cytokine Ab (for example, FITC-conjugated anti-IFNγ) and analyzedby FC. Staining of proteins with Ab reduces the versatility ofconventional FC, particularly in the case of intracellular proteins.Moreover, assays are limited by protocols that require prolongedstimulation of T cells by endogenous antigen presenting cells (APCs),which increases turn-around time and reduces clinical usefulness.

The existing methods for cytokine analysis of individual cells lack theability to rapidly identify low-frequency T cell populations present insmall samples of peripheral blood. The commercial ELISPOT test does notdistinguish between TB and LTBI. Moreover, a positive result in anasymptomatic individual (in the absence of microbiological evidence ofactive TB) is uninformative for reactivation risk. Thus, whileaccurately reflecting the presence of M. tuberculosis infection, apositive result is not considered an indication for therapeuticintervention. This diminishes the acceptability of the test,particularly in low-resource, high-burden countries, where most of thepopulation is infected (up to 80% in regions of South Africa). Moreover,even in low burden, high-resource countries such as the US, the sideeffects of LTBI treatment often lead to its refusal when it isrecommended without an indication of reactivation risk. Clearly, thelimitations of current immunodiagnostics have enormous public healthconsequences worldwide.

Thus, there is an unmet need for methods that rapidly detect geneexpression in individual cells.

SUMMARY

This invention relates to novel rapid methods for detecting various RNAmolecules in individual cells.

Accordingly, one aspect of this invention provides a method fordetecting copies of at least one RNA molecule expressed in individualcells. The method includes (a) providing a sample containing apopulation of cells (e.g., at least 100 or at least 10,000 cells) thatexpress specific receptors capable of initiating signal cascades leadingto gene expression upon binding to them of ligands or stimulatingmolecules; (b) inducing gene expression in the cells ex vivo, eitherimmediately or after culturing, by incubating the cells with at leastone compound, for example, a peptide or mixture of peptides derived froma microorganism (such as M. tuberculosis) that will bind specificreceptors or otherwise initiate signaling and initiate gene expression;(c) fixing and permeabilizing the cells; (d) labeling copies of at leastone RNA molecule expressed by the cells with a set of fluorescentlylabeled oligonucleotide hybridization probes, and washing away unboundprobes; and (e) detecting cells having expression events by flowcytometry (FC), an expression event being one or more fluorescencemeasurements categorized by fluorescence intensity gating.

The aforementioned method can be used for detecting various RNAmolecules in individual cells. In particular, it can be used fordetecting RNA molecules encoded by cytokine genes, such as IL-2, TNFα,or IFNγ.

In the method, the step of inducing can include stimulating T-cellreceptor (TCR) signaling and down-stream gene expression by antigenpresenting cells (APCs) that are present in the cell population or byartificial APC (aAPC). The induction can be carried out for a period offrom 30 minutes to 6 hours. In either case, the step of inducing canalso include co-stimulating with at least one monoclonal antibody (mAb).The monoclonal antibody can be bound to or added to the aAPC or APCs.

In one embodiment of the method, the cell population can be a populationof T cells obtained from human PBMCs. In that case, the at least one RNAmolecule can be one encoded by a cytokine gene. And, cells in the cellpopulation can be induced by APCs or aAPCs with one or morepeptide-loaded MHC molecules that interact with TCR.

In the method, the compound or stimulatory molecules can be derived froma microorganism, such as M. tuberculosis-derived immunogenic peptides.In one example, the compound can contain a peptide or mixture ofpeptides, such as those that associate with MHC class I or MHC class IImolecules. These peptide or mixture of peptides can be added to the APCor aAPC mentioned above at various concentrations, e.g., between 1-20μg/ml.

In the above-described method, the step of inducing can includestimulating toll-like receptor signaling and down-stream gene expressionin a cell containing such receptors with a stimulus, examples of whichinclude cytokines, microbial products or synthetic compounds. Examplesof the microbial product include a lipid, glycan, glycolipid,sulfolipid, glycoprotein, protein, peptide, or nucleic acid (e.g., RNAor DNA). The stimulation can be carried out for a period of from 30minutes to 72 hours (e.g., 30 minutes to 6 hours, 6 hours to 24 hours,24 hours to 72 hours). The stimulus can be present at a concentrationbetween 1-20 μg/ml (e.g., 1-100 ng/ml or 100-1000 ng/ml). The compoundor stimulus can be a cytokine, such as IFNγ, IL-2, IL-15, TNFα, or acytokine other than IFNγ, IL-2, IL-15, or TNFα. In the method, more thanone compound or stimulus can be provided either at the same time or atdifferent times.

In step (d) of the method, the probe set can include 20-60 probes, eachsingly labeled with the same fluorescent moiety.

In another embodiment, the detected cells having expression events canbe separated (e.g., by fluorescence-activated cell sorting) from cellsnot having expression events. The separated cells can include only onecell or more than one cell (e.g., 10, 100, 1000, 10,000 or 100,000cells). Gene expression can then be measured in the separated cells by,e.g., RT-PCR or a transcriptomic analysis of RNA in the cells.

The details of one or more embodiments of the invention are set forth inthe description below. Other features, objects, and advantages of theinvention will be apparent from the description and from the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a graph of fluorescence intensity versus forward scatteredchannel A (FSC-A) for the FC readouts described in Example 2.

FIG. 2 is a set of four frequency plots from FC detection of samplesdescribed in Example 7.

FIG. 3 is a set of six frequency plots from FC detection of samplesdescribed in Example 8.

FIG. 4 is a set of three frequency plots from FC detection of samplesdescribed in Example 9.

FIG. 5 is a set of twelve frequency plots from FC detection of samplesdescribed in Example 10.

FIGS. 6A and 6B are (A) a set of twenty-eight frequency plots from FCdetection of samples probed with mRNA probe sets as described in Example11 and (B) a set of sixteen frequency plots from FC detection of samplesprobed with mAbs as described in Example 11.

FIGS. 7A and 7B are (A) a set of two frequency plots from FC detectionof samples probed with a probe for green fluorescent protein, before(left panel) and after (right panel) additional gating to distinguishthe cells as cytokine-positive and cytokine-negative populations, asdescribed in Example 12 and (B) a set of two frequency plots from FCdetection of samples probed simultaneously with four mRNA probe sets,before (left panel) and after (right panel) additional gating todistinguish the cells as cytokine-positive and cytokine-negativepopulations, as described in Example 12.

FIGS. 8A and 8B are (A) a table showing the threshold cycles ofamplifications of two genes in the sorted (+/−) cell populationsdescribed in Example 12 and (B) a photograph showing an electrophoreticgel of the amplification products from the amplifications described inExample 12.

DETAILED DESCRIPTION OF THE INVENTION

This invention discloses a method for measuring and assessing expressionof one or more genes, including RNA transcripts that code for proteins,for example, messenger RNA (mRNA) and pre-mRNA, and those that do not.

As disclosed herein, the method can be used to assessing RNA transcriptsin cells the gene expression of which changes in response to variousinductions. Induction may be naturally occurring or stimulated by anyknown ligands for cellular receptors including but not limited to TCRsand involve, in principle, any receptor or ligand (for example, Tollreceptor-like or chemokine receptors and their ligands) or compound thatinitiates a signaling cascade and may result in transcript synthesis andexpression of certain genes, for example, at least one cytokine genesuch as IL-2, TNFα, or IFNγ.

In some embodiments, the induction is stimulation by a compound orcompounds that bind specific receptors and thereby initiate geneexpression, for example, a peptide or mixture of peptides associatedwith MHC I or MHC II molecules. The compound or compounds may be derivedfrom a microorganism, for example, stimulatory molecules that are M.tuberculosis-derived immunogenic peptides. Induction of gene expression,for example stimulation of T-cell receptor signaling and downstream geneexpression may be by APCs that are present in the cell population beinginvestigated. Alternatively, stimulation may be by artificial APC(aAPC). A peptide or mixture of peptides that associate with MHC class Ior class II molecules may be added to APC or aAPC, preferably at aconcentration in the range of 1-20 μg/ml to produce peptide-loaded MHCmolecules that interact with TCRs. Certain embodiments of methods ofthis invention include co-stimulation with at least one monoclonalantibody in addition to APC or aAPC. With aAPC, the mAb may be bound tothe aAPCs.

The method of this invention allows one to carry out rapid and sensitivemeasurements of changes in cell population composition and function thatoccur during evolution of infectious or non-infectious disease andassociated progression of pathology. These measurements can characterizethe properties of neoplastic and/or malignant cells of hematopoietic andnon-hematopoietic origin, and of cells involved in autoimmune disease.

The method can also be used in monitoring of response during therapy totreat the disease state. For infectious disease, immune control inresponse to antibiotic therapy can be determined by correlating progressin eradicating a pathogen, for example M tuberculosis, with changes incellular responses to stimulation, such as responses of functionalT-cell subsets to antigenic peptides.

Methods of this invention are generally applicable to virtually allcells, mammalian (including but not limited to human) and lowereukaryotic species, that express specific receptors capable ofinitiating signaling cascades upon ligand/stimulatory molecule binding.They can be applied to populations of bacteria as well as tomulticellular organisms. Certain preferred embodiments are theapplication of methods of this invention to animal cells, including butnot limited to human cells. A suitable source provides a sufficientnumber of cells for detection of rare events and/or for statisticalanalysis. In some embodiments that is as few as 1000 or even 100 cells.In many embodiments, for example where the cells are T cells, a sourcethat provides at least 10,000 cells is preferred. More preferably, thesource provides at least 100,000 cells or at least one million cells.Suitable sources include blood samples and tissue samples, for example,biopsy samples. Tissue samples must be separated into individual cells,that is, disaggregated tissue is required for processing.

As mentioned above, methods of this invention include rapid induction,not exceeding 5 days and preferably less, for example 4, 3, 2, or 1 day,or 16, 12, 10, 8, 6, or 4 hours. A preferred induction time is from 30minutes to 8 hours, preferably from 30 minutes to 6 hours, morepreferably from 30 minutes to 4 hours, and even more preferably from 30minutes to 2 hours.

Methods of this invention include rapidly measuring expression of one ormore genes in immune and non-immune cells based on activation andfunctional consequences induced by ion fluxes, including but not limitedto those caused by ionophores and/or mitogens, or by signaling throughcell surface or intracellular receptors, including but not limited topattern recognition receptors, including toll-like receptors and NOD andNOD-Like receptors, G protein coupled receptors, including chemokinereceptors, polypeptide hormone receptors, cytokine receptors, B cellreceptors, or TCR. Methods according to this invention are believed toadvance medical care for various infectious and non-infectiouspathologies. Preferred embodiments comprise detecting expression of RNA,including both mRNA and pre-mRNA, for one or more cytokines inindividual lymphocytes, whether in isolated PBMC, T cells, or inwhole-blood samples (rather than isolated PBMC) and also other types ofcells as indicated below. Methods according to this invention apply, forexample, to analyzing CD3⁺CD4⁺ T cells (T helper 1 or Th1 cells) thatproduce IL-2, IFNγ, and TNFα; CD3⁺CD4⁺ T cells (T helper 2 or Th2 cells)that produce IL-4, IL-5, IL-6, IL-10, and IL-13; CD3+CD8+ T cells thatproduce (IL-2, IFNγ, TNFα, MIP-1α and other chemokines) and otherspecialized T-cell subsets, including but not limited to Th17 and Tregcells, or other lymphocyte subsets, including but not limited to NKcells, NKT cells, subpopulations of macrophages and dendritic cells,cells comprising endothelia and epithelia of various body organs orcells of the nervous system, including but not limited to neurons andglia, and the pre-mRNA and mRNA for cytokines, chemokines and functionalmolecules (for example, see Table 2) produced by these cells.

Certain methods according to this invention comprise ex vivo stimulationof cells, or induction of specific molecular interactions leading toexpression of activation markers and modulating cellular functions.Stimulation may be performed immediately or performed on cells afterculturing in a culture medium. Stimulation may be natural, that is,simply incubating the cells in culture. Preferably, stimulation may bepromoted by incubating the cells in culture with one or more compoundsthat trigger specific receptors/ligands and induce signaling cascades.These compounds may be synthetic or derived from microorganisms,including but not limited to bacteria, viruses and fungi, for example,lipopolysaccharides, lipoarabinomannans, peptidoglycans, mycolic acidsof bacterial origin, or proteins of viral origin, including but notlimited to Epstein Barr virus or cytomegalovirus (for example, proteinsebvIL-10, cmvIL-10 and UL146, respectively), or fungal (for example,Cryptococcus- and Aspergillus-associated) galactoxylo- andgalactomannans and soluble antigens; polypeptide hormones, for example,platelet-derived growth factor or VEGF; cytokines; and antigens,including antigenic peptides. A preferred method of stimulation is withartificial antigen presenting cells (aAPC; see below).

Methods according to this invention further include detection ofindividual cells, including particularly activated cells, having abiomarker signature, preferably a multiple biomarker signature, namelyone or more RNAs, including particularly mRNAs or pre-mRNAs in situ inintact cells.

Preferred methods according to this invention comprise detecting inducedgene expression, for example for cytokines, and most preferably formultiple cytokines, in individual cells, for example activated T cells,by labeling expressed RNA molecules, including mRNA or pre-mRNAmolecules, in fixed, permeabilized cells utilizing sets of fluorescentlylabeled hybridization probes and washing away unbound probes.Single-molecule sensitivity is obtained by employing multiple nucleicacid hybridization probes that provide multiple fluorescent labels foreach RNA target. These may be a small number of probes multiply labeledwith a particular fluorophore or probes labeled to produce fluorescenceby fluorescence resonance energy transfer (FRET) when they arehybridized to cognate mRNA or pre-mRNA. Preferred methods of thisinvention utilize a larger number, for example, 10-100, more preferably20-60, even more preferably 30-50, for example about 50, shorteroligonucleotide probes, each labeled with a single fluorescent dye, thatbind simultaneously to a target sequence. The attachment of many labelsto each RNA molecule renders the cell sufficiently fluorescent abovebackground that it can be detected by FC methods.

Further, methods according to this invention include detection andanalysis of individual cells expressing target RNA or RNAs by FC.Certain preferred methods of this invention comprise using quantitativeFC to detect cells that include RNA expression products of cytokinegenes induced in desired cells by APC or aAPC stimulation.

FC comprises a fluidics system for hydrodynamic focusing to create asingle file of cells. Single cells can then be interrogated forfluorescence emission at one or multiple wavelengths. FC is a routinetechnique in clinical pathology laboratories. For example, immunephenotyping by FC is an important tool in the diagnosis and staging ofvarious haematologic neoplasms. Essential FC steps are labeling cellswith one or more fluorescent moieties, for example fluorophores,introducing labeled cells into a flow cytometer, illuminating each cellwith an excitation light source such as a laser that emits at awavelength that excites the fluorescent moieties, and detecting emittedfluorescent light using filters and mirrors that distinguish specificemitted wavelengths for each fluorescent moiety being used, so as toacquire data that reveal the presence and, preferably, the amount ofeach fluorescent moiety associated with each cell based on theexcitation and emission.

As disclosed herein, FC can be used for detecting cells expressing RNAby utilization of multiple singly-labeled fluorescent hybridizationprobes. A most preferred embodiment is detection of RNA (mRNA orpre-mRNA) expressed from cytokine genes in the T-cell fraction ofisolated. PBMC that had been stimulated by presentation of Mtuberculosis Ags by either endogenous APC or, more preferably, aAPC. RNAfor multiple cytokines can be detected by use of probes that arespecific for each species of RNA and that are labeled with a differentfluorescent moiety (for example, a different fluorophore) for eachspecies of RNA detected.

In methods of this invention, FC is performed on populations of cells(from as few as 10,000 cells to more than one million cells). Data areacquired for one or more events. An event is a set of measurements forone cell. The data for each event are categorized into user-definedwindows, for example, signal for fluorophore A, or signal forfluorophore A that is between an intensity level X and an intensitylevel Y. The categorization of FC readings is a process called gating,and the events are thus gated, or selected, typically as above a certainthreshold or bounded by certain threshold limits. Results can then bepresented as absolute numbers of cells in a certain window or,preferably, as a fraction of cells in one or more windows, that is,frequency. For example, in analyzing a disease state, the results mightbe that 10% of the cells were positive for mRNA A and mRNA B, 7% of thecells were positive for mRNA B and mRNA C, and 2% of the cells werepositive for all three of mRNA A, mRNA B and mRNA C. If 10,000 cells areanalyzed, the lowest possible positive result is that a certain eventoccurred once in 10,000 cells. If, on the other hand, one million cellsare analyzed, the lowest possible positive result is that a certainevent occurred once in one million cells.

Analysis of FC results may include analysis of variance (ANOVA), whichis a collection of statistical models for analyzing variances, generallyto test significant differences between means for groups or variables bypartitioning total variances into components due to true random errorand components due to differences between means.

This invention also discloses reagent kits for carrying out theforegoing methods. Kits according to this invention include at least onestimulatory compound, for example proteins or peptides that willstimulate expression of one or more cytokines, as a responsecharacteristic of the disease state to be tested, or aAPC that areloaded with such peptides and that carry co-stimulatory molecules asdescribed below, and one or more sets of oligonucleotide probes thateach hybridize specifically to a single sequence present in mRNA orpre-mRNA, preferably wherein each set comprises 20-60 oligonucleotidesof 16-20 bases each and each oligonucleotide is labeled with a singleflourophore. The kit may additionally comprise other than mRNA-specificprobes such as fluorophore-conjugated Abs recognizing cellular proteinsor chemical probes tagged with fluorophores binding to targets ofinterest, reagents for fixation and permeabilization of cells to beanalyzed, reagents for hybridization of the included probes with thecells, and reagents for post-hybridization processing, such as washes toremove excess, non-hybridized probe(s) or other unbound labeled probes.

In a preferred embodiment, the method of this invention includesstimulation of TCR signaling and down-stream gene expression by APCsthat are present in a cell population or by synthetic beads, which arereferred to herein as aAPC. Synthetic beads serve as a mechanicalsupport, i.e., a platform to which proteins (MHC and/or co-stimulatoryreceptors and ligands) can be attached via chemical, charge or any othertype of bonding. Therefore, for example, any plastic surface could beused with or without chemical modification or derivatization asnecessary, to serve as a mechanical support, or platform, for aAPC.

The APC interact (or react) with added peptides (or proteins) so thatthey are associated with (or endogenously processed and presented by)MHC molecules and then can stimulate TCR. The aAPC interact with addedpeptides that bind to MHC molecules and these peptide-loaded aAPC canthen stimulate TCR. The aAPC thus carry one or more classes ofpeptide-loaded MHC molecules to interact with TCR, with or without oneor more antibodies or other type of ligands that interact withco-stimulatory receptors expressed on T cells, such as CD28 and/orCD49d. In certain preferred embodiments stimulatory peptides are M.tuberculosis-derived immunogens. The step of stimulating TCRs comprisesincubation of TCR-expressing cells with APC or aAPC that comprise MHCclass I or class II molecules loaded with appropriate peptides, and, insome embodiments, with co-stimulatory proteins or functional equivalentssuch as antibodies, peptides, various carbohydrate- and lipid-bearingmolecules that bind their targets on co-stimulatory receptors thatenhance signaling, resulting in T cell activation.

Functionally different T-cell subsets are often expressed at frequenciesclose to current detection limits (generally 0.01-0.1%). Thus, theirdetection requires potent TCR stimulation and highly sensitive detectionmethods so that even rare T-cell subsets can be directly detected orexpanded to numbers above the detection limit of the particular assaymethod. Methods of this invention comprise inducing effective TCRstimulation by APC that are present in a cell population or by or aAPC,a synthetic bead-based platform containing (i) MHC class I or class IImolecules loaded with appropriate peptides and, in certain preferredembodiments, (ii) co-stimulatory proteins (anti-CD28 and/or anti-CD49dmonoclonal antibody) that provide additional signals (Oelke et al.,2003, Nature Medicine 9(5):619-24]. Virtually any MHC allele can beattached to the bead platform and any co-stimulatory signal can beprovided as a bead-attached specific monoclonal antibody (mAb) orco-receptor ligand, whether naturally occurring or chemically defined.In addition to their superior properties of stimulation, aAPC are verystable: the final cell-sized aAPC, with or without bound syntheticpeptides, have a long shelf life in a lyophilized form, and are readilytransportable.

In methods of this invention, the procedure for stimulation generallyincludes obtaining the desired cells from a subject, incubating thecells in culture media, and adding compounds for stimulation of thecultured cells for various times, such as 30 minutes, 1 h, 2 h, 4 h, 6h, 8 h, 10 h, 12 h, 14 h, 16 h, or longer periods (e.g., 1, 2, 3, 4, or5 days). Cells might be obtained by biopsy of solid tissue or aspirationof cells in liquid from a site of interest, such as by bronchoalveolarlavage, or the source of the cells may be peripheral blood. Desiredcells may be cultured after separating them from unwanted cells bylysing those cells and separating the intact desired cells from theremnants of lysed cells, or by separating the desired cells from theundesired cells based on specific cell characteristics. For example,PBMCs from blood may be cultured either after lysis of red blood cells(RBC) or after recovery based on cell density by sedimentation on Ficolland removal of Ficoll prior to incubating in culture media. Stimulationcan be achieved by adding a stimulating compound as described above(such as a bacterial, fungal, or viral product, or a host protein orpeptide) in an amount sufficient to produce the response that will bedetected and incubating for a time sufficient to produce the response.The response may be synthesis of a pre-mRNA or mRNA by the cultured,stimulated cells. The response may be interpreted as a signaturecharacteristic of the desired cells' response to the stimulus given.

For obtaining signatures of M. tuberculosis infection, for example,HLA-A*0201-based aAPC can be loaded with HLA-A*0201 epitopes (peptides)known to bind to the human HLA-A-0201 MHC class I protein derived fromknown Ags such as Rv1886c, Rv3874 and Rv3875, and the Ag loaded,A2-based aAPC can be mixed with PBMC at a 1:1 ratio under standardculture conditions for detection of CD8+ T effectors. HLA-DRB1*04-basedaAPC can be similarly loaded and used for detection of CD4+ T effectors.

For detection of cells containing copies of one or more specific RNAs,one can utilize for each RNA a set of multiple, fluorescently labeled,oligonucleotide hybridization probes. The oligonucleotide probes may beDNA, RNA, or mixtures of DNA and RNA. They may include non-naturalnucleotides, nucleotide analogs and non-natural inter-nucleotidelinkages. Each probe may be labeled with multiple fluorescent moieties,for example, multiple copies of a fluorophore, Quantum Dot, or otherfluorescent moiety. For example, WO/1997/014816 describes detection ofbeta- and gamma-actin mRNAs by a single-step in situ hybridizationutilizing five probes per target, the probes being about 50-nucleotidelong single-stranded DNA labeled with a fluorophore (Fluorescein or Cy3)every tenth nucleotide, that is, five fluorophores per probe. Preferredmethods of this invention utilize a larger number, for example, 10-100,more preferably 20-60, even more preferably 30-50, for example about 50,shorter oligonucleotide probes, each labeled with a single fluorescentdye, that bind simultaneously to a target sequence. The attachment ofmany labels to each RNA molecule renders the cell sufficientlyfluorescent above background that it can be detected by FC methods. Inmost embodiments, each probe set will have a single fluorescent moiety,and each fluorescent moiety will be detectably distinguishable fromother fluorescent moieties that are present. If one is detecting whetheror not each cell expresses a first RNA or a second RNA, however, bothprobe sets could be labeled with the same fluorescent moiety.

Background fluorescence presents a different problem for methods of thisinvention, which utilize FC, than from microscopic smFISH methods, whichutilize microscopic visualization of individual RNAs as bright spots incells. Methods of this invention may employ background reductiontechniques. One such technique is to employ FRET between probes thatalign adjacently on a target RNA. Considering, for example, a firstprobe and a second probe that align adjacently with the 5′ end of thefirst probe adjacent (within appropriate FRET distance, as is known) tothe 3′ end of the second probe, one may add a FRET donor to the 5′ endof the first probe and add a FRET acceptor to the 3′ end of the secondprobe. With this combination, cells are excited at the absorptionwavelength of the donor fluorophore, for example Fluorescein, but signalis detected at the emission wavelength of the acceptor fluorophore, forexample Texas Red. Because Texas-Red fluorophores are not exciteddirectly, unhybridized probes or mis-hybridized probes do not fluoresce.Another technique is to employ FRET between a double-strand DNA dye anda fluorophore of a probe set, as is performed in probing with Resonsenseprobes. In this case a dsDNA dye such as SYBR Green is included (SYBRGreen has absorption and emission wavelengths very similar toFluorescein), and a probe set is labeled with a fluorophore that acceptsemission from SYBR Green, for example, TMR. With this combination onecan excite the cells at the absorption wavelength of SYBR Green, butdetect emission at the emission wavelength of the fluorophore. Becausethe fluorophore is not excited directly, unhybridized probes do notfluoresce.

Although all regions of an RNA can serve as targets for probes, severalfactors should be considered in the selection of such probes. Preferablythe target region should not be expressed in the cell from other regionsof the genome, or more preferably, the target region should not bepresent elsewhere in the genome. This can be ensured by checking thesequence of the desired target against the databases that list theexpressed genes and the entire genome sequences for the organism beingstudied. This “filtration” of the potentially background-generatingsequences can be performed using publically available computer programssuch as “repeat masker.” The probes can be selected from immediatelyadjacent regions of the targets or there can be some space betweenadjacent probes. The length of the probes can vary depending upon thestringency of hybridization.

As shown below, Example 1 demonstrates induction and probing indistinguishing characteristic signatures of gene expression in singlecells.

More specifically, assays were carried out to test differentiated THP-1cells stimulated with irradiated M. tuberculosis. Cells were fixed byincubation for 20 minutes with 4% paraformaldehyde after 24 hours ofstimulation and then hybridized with probes for two mRNA targets. Onewas TNFα, a key target for analysis of activated T cells andmacrophages. The other was ACSL1 (a lipid metabolism gene, GenBankAccession #BC050073.1), which is also expected to be induced by thestimulus. The probe set specific for TNFα (Ensembl Sequence IDENST00000376122) comprised 48 probes, each about 20 nucleotides long andterminally labeled with a tetramethylrhodamine fluorophore. The probeset specific for ACSL1 comprised 48 probes, each about 20 nucleotideslong and labeled with an optically distinguishable fluorophore, namely,AlexaFluor 596.

For Example 1, expressed RNA products were detected using the knownmicroscopic technique described in Raj et al., 2010, Methods inEnzymology 472:365-386; and Raj et al., 2008 Nature Methods 5: 877-879,namely, smFISH. This technique comprises detection of fluorescent spotsas an indication of hybridization of a probe set to an individual RNAmolecule. In Example 1, spots corresponding to both mRNAs were detected.Images for TNFα and ACSL1 were merged 3-D stacks for each channel forthe same set of cells. Interpretation comprised image processing using acomputer program to identify the diffraction-limited spots,corresponding to the individual molecules of mRNA, overlaying them on aDIC image of the cells, and obtaining a cell-by-cell count of the numberof mRNA molecules, as described in the references. A large cell-to-cellvariation in the number of transcripts for each gene was observed,consistent with previous observation that mRNA synthesis in mammaliancells is highly stochastic. The results, the average spot number forTNFα in stimulated and unstimulated cells based on the total number ofspots counted in 50 consecutively analyzed cells, showed that singlecell measurements are far more informative than ensemble measurements.

FC data acquisition for methods of this invention can be carried out byconventional FC techniques. Light can be detected in both a forwardscatter channel (FSC) and a side scatter channel (SSC). Data can bepresented as either or both of density plots and contour diagrams. Tovisualize cells of interest while eliminating results from unwantedparticles, for example debris, FC gating is used. Gates and windows, orregions, are determined in the conventional manner such that positiveevents appear in a window. To assist in gating to discriminate truepositive events from false positives, use of a negative control, thatis, probing for something that the cells could not express, is helpful.In principle this is analogous to FC for proteins, where an isotypenegative control and/or unstained cells are utilized.

FC detection reveals the number of positive events in a sample, forexample, one positive event in 10,000 cells (1/10,000), three positiveevents in 100,000 cells (3/100,000), or two positive events in onemillion cells (2/10⁶). The frequency of an event may lead to aconclusion as to a biological state, for example, a disease state.Alternatively, combinations may do so; for example, 10% of cells in asample are positive for a first cytokine (cytokine A) and also positivefor a second cytokine (cytokine B). As another example, a disease statemight be characterized by the following combination: 10% or more ofcells being positive for cytokines A and B; 7% or more of cells beingpositive for cytokine B and a third cytokine (cytokine C); and 2% ormore of cells being positive for all three cytokines.

As disclosed herein, it was demonstrated that FC is useful as a read-outfor methods of this invention. The experiment described below in Example2 was designed to test whether signals generated by probe setshybridized to RNA targets in individual cells can be detected by FC.That example describes steps to detect HIV GAG mRNA in cell culturesexpressing it from a lentiviral construct. More specifically, 293T cellswere transfected with three plasmids that together allow expression of arecombinant lentiviral construct and hybridized with probes specific forGAG mRNA. FC results are presented in FIG. 1, graphs of fluorescenceintensity versus forward scattered channel A (FSC-A) obtained from cellsthat were not transfected, on the left, and cells transfected with thethree plasmids from a lentiviral packaging system, on the right. Bothsets of cells were hybridized with a probe set for GAG mRNA. Thepopulation of transfected cells produced signals of intensity that was1-2 orders of magnitude greater than seen with the signals from theoutlier untransfected cells (i.e., those above the set threshold). As acontrol, image-based analysis of smFISH results indicated that about 25%of the cells were expressing the construct. The FC analysis on the samepopulation found the same fraction of cells to be fluorescent. Theseresults demonstrate that mRNA expression is readily detected by FC.Moreover, the data provide guidance for distinguishing a low frequencyof strongly stimulated (brightly fluorescent) T cells from outliers inthe non-stimulated population. Receiver operating curve (ROC) analysiscan define an optimal threshold. ROC analysis is well known to thoseversed in the art of test development. See, for example, Zweig et al.,1993, Clinical Chemistry 39 (8): 561-577 and Pepe, 2003, The statisticalevaluation of medical tests for classification and prediction. New York,N.Y.: Oxford.

The challenges in the detection of transcriptional signatures of T cellactivation are two fold—only a small subset of cells are induced and theinduced cells express only a few copies of mRNAs per cell. Inexperiments described in Example 7, the inventors were able todemonstrate both sensitive detection of low frequency responses andsimultaneous detection of several mRNA targets by methods of thisinvention. The assay, which included stimulation, probing of fixed cellsand FC, was able to detect cells expressing the IL-2/IFNγ pair withfrequency of 3.46% (FIG. 2, right panel), while cells expressingIL-2/TNFα and IFNγ/TNFα cytokine pairs were detected with frequencies of3.35% and 6.37%, respectively. Comparisons of single- anddouble-cytokine populations, e.g., IFNγ (4.76-5.40%) vs. IL-2/IFNγ(3.46%), suggested that not all IFNγ producers could produce IL-2. Incontrast, most IFNγ producers (5.40%) seemed to also express TNFα, assuggested by the size of IFNγ/TNFα-producing population (6.37%). Thisresult is expected for a population of T cells non-specificallyactivated by combined TCR triggering and lectin-mediated stimulation(anti-CD3 mAb and phytohemagglutinin). Thus, the assay according to thisinvention gave results consistent with known T cell biology.

As shown in Example 8, a method according to this invention was appliedfor the detection of M. tuberuclosis-specific cells stimulated ex vivo.PBMC were incubated for 5 h with a mixture of ESAT6- and CFP10-derivedpeptides (T-SPOT.TB, Oxford Immunotec, UK) at 5 μg/ml. As shown in FIG.3, there was a ˜2-fold increase in cells expressing cytokine mRNAs inAg-specific T cells after this stimulation. Therefore, even in theabsence of co-stimulation provided by anti-CD28 mAb, the assay detectedlow frequencies of circulating M. tuberculosis-specific T cells presentin this LTBI donor. This result demonstrates the utility of assaysaccording to this invention.

Example 9 describes a method according to this invention with increasedsignal as compared to Example 8. Engagement of CD28 co-receptor of TCRby mAb was used to deliver superior stimulation of Ag-specific T cells.As shown in Example 8, PBMC were incubated for 5 h with a mixture ofESAT6- and CFP10-derived peptides (T-SPOT.TB, Oxford Immunotec, UK) at 5μg/ml, but this time with or without anti-CD28 mAb 53D10. Fixed andwashed cells were incubated with Cy5-labeled DNA probes specific forgreen fluorescent protein (GFP, negative control) or IFNγ, and thenanalyzed by FC. The frequencies of cytokine producers are shown in FIG.4. More than a 2-fold increase in expression of IFNγ mRNA occurred inAg-specific T cells of LTBI donor in the presence of anti-CD28 mAb.Non-specific hybridization with control GFP and HIV-1 GAG probes was notaffected by CD28 co-stimulation. Example 9 illustrates a distinctstrategy to amplify the signal, namely, by providing co-stimulatorysignals to TCR specifically engaged by cognate Ag. Furthermore, sinceco-stimulation mediated by anti-CD28 mAb did not affect non-specificbinding of control probes (GFP and HIV-1 GAG), co-stimulation can beused to increase the strength of a specific signal over backgroundnoise.

Several strategies are particularly helpful for optimization of assaysaccording to this invention. They include the following:

i) Kinetics of Signal Detection.

Kinetics of mRNA analyte expression for each of the RNA targets (forexample, mRNA for cytokines IL-2, IFNγ and TNFα) are determined withcells of a given source (for example, Ficoll-separated PBMC obtainedfrom blood samples of LTBI+ and LTBI− donors) that are stimulated withan appropriate inducer or inducers (for example, a mixture of Ags (forexample, ESAT6- and CFP10-derived peptides (T-SPOT.TB, Oxford Immunotec,UK) present at 5 μg/ml), as in Example 8. Expression of each cytokine isthen assayed separately in Ag-stimulated. PBMC at various times (forexample, 30 min, 2, 4, 8, 12, and 16 h). Particularly for cytokines,PBMC non-specifically stimulated with anti-CD3 mAb andphytohemagglutinin (PHA) serve as positive controls of stimulation. Inan assay for analysis of specific PBMC response, a preferred method formeasuring non-specific response utilizes and compares PBMC frompopulations that comprise individuals known to be unaffected andaffected by the condition for which the specific response is measured.

ii) Dose Response.

Dose response to Ag stimulation can be similarly determined (forexample, for each of the three cytokines) by varying concentrations (1to 20 μg/ml) of ESAT6 and CFP10 peptide mixture at the optimal signaldetection time point. Additionally, non-specific stimulation(anti-CD3+PHA) of PBMC from any donors can be optimized by testingvarious concentrations, separate and in combination, to provide astandard positive control for a particular assay. In an assay foranalysis of specific PBMC response, a preferred method for measuringnon-specific response utilizes and compares PBMC from populations thatcomprise individuals known to be unaffected and affected by thecondition for which specific response will be measured.

iii) Signal to Noise Amplification.

Probe sets with more or more highly intense fluorophores can bedesigned. This goal will also be achieved through several improvementstrategies. Additionally, probe labeling methods can be modified asdescribed earlier. Hybridization stringency can be optimized empiricallyin order to increase signal/noise ratio.

A distinct strategy to amplify the signal is by providing co-stimulatorysignals to TCR specifically engaged by cognate Ag, as described inconnection with Example 9. Conditions for co-stimulation can beoptimized as outlined above for kinetics and dose-response to achieverobust detection of multiple RNAs (for example, three cytokines) byassay described herein.

iv) Threshold Determination.

Initial evaluation of a threshold for RNA detection can serve tostandardize the optimized assay, although the clinically acceptedthreshold for a particular assay can be determined at a later point ofcommercial assay development. In the research phase, one can evaluatethe threshold of RNA detection (cytokine expression) in Ag-specific Tcells obtained from donors and stimulated ex vivo. The Ag-specificresponses can be calculated by subtracting signal from unstimulated PBMCfrom the values obtained with Ag-stimulated PBMC at optimal time and Agdose. For each cytokine read-out, a ROC (receiver operatingcharacteristic) curve is estimated to show the trade-off betweensensitivity and specificity at various cut points (including the mean ofthe donors plus two standard deviations), and optimal threshold valuesare selected to identify Ag-specific responses.

v) Reduction of Blood Volume and Processing Time.

Currently, 2×10⁶ cells/parameter (for example, each cytokine) thatcorresponds, on average, to 0.8 ml of blood, are analyzed. Byintroducing red blood cell lysis of the whole blood instead of Ficolseparation in PBMC preparation, and further blood processingmodifications such as vacuum-driven sedimentation (96-well format)instead of centrifugation, one can reduce sample volumes and shorten thetime of assay. Preliminary experiments indicate that the hybridizationtime can be reduced to 2 hours (hrs) without a significant loss ofsignal.

Assay development can proceed by conventional methods. For example, PBMCfrom three donor groups (active TB, LTBI, and non-infected controls) canbe stimulated with HLA-A2- and HLA-DR4-based aAPC loaded with ESAT6 andCFP10 peptides, as in Example 4. Each assay can test a panel of 4markers of response to stimulation (assayed together based on expressionproperties) chosen from a group including but not limited to genes shownin Table 1 using 4-color FC for analysis. This allows all targets to beassessed for each donor. Markers selected in initial tests can bere-tested in combinations chosen to group together genes expressed atsimilar levels in each group. Statistical analysis can be performed asdescribed in Example 4. Where desired, one can also measure expressionof targets induced by conventional APC stimulation to confirm theability of aAPC to improve detection sensitivity for multiple analyteswithin single cells. Further, an assay can also be tested byfluorescence microscopy. Statistical analysis can be performed asdescribed in Example 5.

The experiment described in Example 10 demonstrates that the samemethodology, which is referred to as “FISH-Flow” used for detection ofcytokine mRNAs expression in T cells, can be successfully utilized inother types of cells, including but not limited to primary macrophages.Moreover, the experiment demonstrates that responses to differentstimuli can be distinguished in primary macrophages by monitoringexpression of a single gene at different times.

The results shown in FIG. 5 show that background expression assessed bya GFP negative control remained constant but negligible (approx.0.1-0.2% of gated cells). Treatment with a mixture of lipopolysaccharide(LPS) and IFNγ orN-palmitoyl-S-[2,3-bis(palmitoyloxy)-propyl]-(R)-cysteinyklysyl)3-lysine(Pam₃CSK₄) readily induced expression of TNFα transcripts in thesecultured macrophages to levels of 6 to 42% of all cells being positive.Robust expression of TNFα transcripts is expected in activatedmacrophages and contrasted with a modest (less than 2%) expression ofIFNγ mRNA, which was unaffected by the choice of stimuli and/or lengthof stimulation and thus may reflect an unusually high background inthese cells rather than the real expression profile. The kinetics ofTNFα mRNA expression induced by LPS and IFNγ appears to be differentfrom that induced by Pam₃CSK₄, with the former stimulation resulting ina sustained prolonged elevation of mRNA levels. In contrast, stimulationof the same mRNA by Pam₃CSK₄ was significantly less persistent.

Example 11 demonstrates identification of temporal profiles of geneexpression for cytokines, chemokines, and chemokine receptors, which aremarkers of T cell activation, in stimulated human T cells, comparingflow cytometry results obtained using FISH probes specific for theindicated mRNAs (FIG. 6A) or using mAbs recognizing their proteinproducts (FIG. 6B). The frequencies of cytokine producers by FISH-Flow(FIG. 6A) showed that expression of IL-2, IFNγ, TNFα, CCL3, CCR7 andcFos mRNAs in non-stimulated cells is either negligible (control GFP,IL-2, IFNγ and CCR7) or very low (TNFα, CCL3 and cFos), occurring in <1%of gated cells. Unexpectedly, induced expression of these mRNAs seems topeak at 2 hours after stimulation and then to decline through 1 day and3 day time points. This is in contrast to the parallel data obtainedwith the same cells (in the presence of 1 μg/ml brefeldin A) byconventional mAb immunostaining and flow cytometry. Here, non-stimulatedcells clearly show basal levels (1-3%) of protein expression detectedfor at least some markers such as IL-2, IFNγ and TNFα in comparison to anegative control—isotype-matched (Iso) mAb. Furthermore, all the targetsare induced at 2 hours and remain elevated in the 3 day time periodexamined. Thus, no distinct temporal profiles could be detected withmAbs that bind to the cytokines. Example 11 demonstrates differences inkinetics that provide superior profile discrimination with FISH-Flowversus conventional mAb staining and flow cytometry and suggests thatthe former method provides greatly improved sensitivity for detection ofactivation.

In order to fully define any cell type functional signatures (i.e.,capability to perform specialized biological functions), knowingexpression of all other mRNAs in activated cells vs. non-activated(non-responding) cells may be important. The study reported in Example12 demonstrates that FISH-Flow enables labeling of cells that expressone or multiple targets in response to stimulation, and that suchresponders could be isolated from the whole cellular population for thepurpose of interrogating their gene expression profiles.

Stimulated human T cells were incubated either with Cy5-labeled DNAprobes complementary to RNA specific for GFP and analyzed by FC as acontrol or with a mixture of several FISH probe sets (Table 3) reactivewith IL-2, IFNγ, TNFα, and CCL3 mRNAs, all probes singly-labeled withCy5. Results obtained with the GFP probes are shown in FIG. 7A. Resultsobtained with the probes mixture are shown in FIG. 7B. After gating forthe lymphocyte population (left panel in each figure), conservativeadditional gating was applied to separate the analyzed lymphocytes intotwo distinct populations (right panel in each figure) that woulddistinguish cells expressing IFNγ (IFN+) from the non-expressing cells(IFN−). The gating set up for GFP-probed cells (FIG. 7A) defined twopopulations, 0.1% in the IFN+ population and 71.2% in the IFN−population, out of all analyzed lymphocytes. TheIL-2:IFNγ:TNFα:CCL3-probed cells (FIG. 7B) were 10.2% IFN+ and 33.7%IFN− with the same gating. The latter FISH-probed cells (FIG. 7B) wereseparated into the positive and negative populations byfluorescence-activated cell sorting (FACS) in order to perform geneexpression analysis on isolated activated and non-responding cells. Thesorted cell populations were analyzed to demonstrate distinct geneexpression profiles consistent with their reactivity with specific FISHprobes. Expression of mRNAs encoded by two genes, IFNγ and“housekeeping” GAPDH (control), was chosen to exemplify an embodiment ofthis aspect of the invention. The sorted cell populations were subjectedto RT-PCR using primers specific to one of the two genes. Quantitativemeasurement of amplified product was made by including SYBR Green dye inthe amplification reaction mixture. Results, shown in FIG. 8A,demonstrate that IFNγ-specific primers detect a greater abundance oftarget in IFN+ cells that were identified with probes for IL-2, IFNγ,TNFα and CCL3 than in IFN− cells that were minimally labeled with thoseprobes. Amplification of a control GAPDH signal that is unaltered byactivation status is expected to be similar in both activated andnon-responding cells. Slightly reduced amplification seen withGAPDH-specific primers in activated cells reflects the fact that thissorted population is significantly smaller, and, therefore, could yieldless mRNA.

These results (confirmed by size analysis, FIG. 8B) demonstrate thatgene expression may be further analyzed in desired subpopulations ofcells identified using the FISH-flow platform of this invention byapplying methods known to those well-versed in the art for sorting andobtaining subpopulations of cells, and methods for gene expressionmeasurement such as RT-PCR or transcriptomic analysis. The subpopulationthat can be identified and studied may contain one cell or more than onecell, including but not limited to 10, 100, 1000, 10,000, 100,000, ormore cells.

EXAMPLES Example 1. Demonstration of Induction and Probe Sets

This example demonstrates the use of artificial stimulation of cells toproduce RNA, in this case mRNA, and the use of sets of singly labeledfluorescent probes to hybridize to expressed RNAs.

For this example, the technique of smFISH was used to visualize spotscorresponding to individual molecules of mRNAs bound to the probes. SeeRaj et al., 2010, Methods in Enzymology 472:365-386; and Raj et al.,2008, Nature Methods 5: 877-879. The probe hybridization conditions andcell washing conditions are described in these references. The proceduredeparted in one important way. In order to avoid the loss of cellsduring washing steps 0.5% fetal bovine serum was included in the washingsolutions. A set of nucleic acid probes, here DNA probes, were selectedfor TNFαmRNA, a key target for analysis of activated T cells andmacrophages, and tested differentiated THP-1 cells stimulated withirradiated M. tuberculosis. Also included were a second set of DNAprobes, labeled with a fluorophore of different color and designed tobind to ACSL1 mRNA (a lipid metabolism gene). The latter gene was alsoexpected to be induced by the stimulus. The probe set specific for humanTNFα comprised 48 probes, each about 20 nucleotides long and terminallylabeled with a tetramethylrhodamine fluorophore. The probe set specificfor human ACSL1 gene comprised 48 probes, each about 20 nucleotides longand labeled with an optically distinguishable fluorophore, namely,alexafluor 594. The sequences of the probes are listed in the sequencelisting at the end of this description (Table 3). Although the probeslisted in each set are suitable for detection of the target mRNA,alternative probes selected from different regions of the target RNAscan also be used as described in Raj et al., 2010, Methods in Enzymology472:365-386; and Raj et al., 2008, Nature Methods 5: 877-879. Asdiscussed above, spots corresponding to both mRNAs in the cells weredetected. The number of TNFα RNA molecules increased from 0.24 per cellwithout induction to 14 per cell, on average, following stimulation.

Example 2. Use of FC to Detect Cells Expressing a Gene

In this experiment assays were carried out to detect HIV GAG mRNA incell cultures expressing a lentiviral construct.

Briefly, 293T cells were transfected with three plasmids that togetherallow expression of a recombinant lentiviral construct and hybridizedwith probes specific for GAG region of HIV mRNA (GenBank Accession#AY835771.1). The sequences of the probes are listed at the end of thisspecification (Table 3). The probes were hybridized and the cells werewashed according to the procedures described in Raj et al., 2010,Methods in Enzymology 472:365-386; and Raj et al., 2008, Nature Methods5: 877-879, which are incorporated by reference herein in theirentireties. Again, to avoid the loss of cells during washing steps, 0.5%fetal bovine serum was included in the washing solutions. FC was thenperformed to detect cells expressing the construct. A gate wasestablished based on the fluorescence of cells that were nottransfected. In cells that were transfected, about 25% of the cellsexpressed the construct as shown by signal of greater intensity than thelevel set by the gate. FC results are presented in FIG. 1, which showstwo graphs of fluorescence intensity (“a.u.”) versus forward scatter(“FSC-A”). The graph on the left (Lentivirus−) shows cells that were nottransfected. The graph on the right (Lentivirus+) shows cells that weretransfected with three plasmids from a lentiviral packaging system.

Example 3. Detection of Cytokine Gene Expression Stimulated by M-TBDerived Peptides

PBMC are obtained from uninfected, asymptomatic latent infection (LTBI),and active TB donors. T cells are activated by addition of the peptidemixture used in the T-SPOT.TB IFNγ Release Assay (IGRA) (OxfordImmunotec, Marlborough, Mass.) according to the manufacturer'sinstructions, which is derived from immunodominant mycobacterial AgsRv3875 (ESAT6) and Rv3874 (CFP10). At various times (4 to 120 h),stimulated cells are fixed and permeabilized and then hybridized withone or more of the probe sets described below. The cells are analyzed byFC to determine the frequency of cells that express the targets,individually and in combination, using available filter sets thatdistinguish among the fluorophores used to label the probes.

The probe set for TNFα is the probe set specified in Example 1. Twoadditional probe sets, one for TL-2 and one for IFNγ are prepared, eachhaving 50 probes (Ensembl Sequence IDs ENST00000226730 andENST00000229135 respectively). The probes in all three sets are linear(random coil) oligonucleotides 15-25 nucleotides long, labeled with asingle fluorophore. The three fluorophores used for the three sets areoptically distinguishable. These three cytokine genes are known markersfor T-cell activation and proliferation that distinguish T-cellsubtypes. The target transcripts are sufficiently long to permit the useof at least 50 probes for each.

To detect marker expression in a small fraction (≤0.01%) of cells by FC,results for 1×10⁶ events are collected. To determine statisticalsignificance for differences between donor groups, a threshold forseparation of non-responsive from responsive cells is determined by ROCanalysis (see, e.g., Zweig et al., 1993, Clinical Chemistry 39 (8):561-577 and Pepe, 2003, The statistical evaluation of medical tests forclassification and prediction. New York, N.Y.: Oxford), and thefrequency of positive cells is determined. A mixed-model ANOVA can beused to analyze the data. Data is transformed (e.g.,log-transformation), prior to analysis. In cases where a simpletransformation is insufficient to address ANOVA assumptions, anon-parametric analog of the statistical approach is applied.

A detectable frequency of expression for all three markers is found inthe activated cells. The frequencies of cells that express differentcombinations of the markers is the signature of the disease.

Example 4. Assay for M. Tuberculosis-Specific Effector T Cells

This example describes assays for detecting M. Tuberculosis-specificeffector T cells.

a. Detection of CD8+ T Effectors.

TB patients are HLA typed by FC detection of PBMC immunostained withallele-specific mAbs BB7.2 and 0222, or by PCR confirmation.HLA-A*0201-based aAPC is loaded with known individual HLA-A*0201epitopes (peptides) derived from Rv1886c, Rv3874 and Rv3875.

These peptides are derived from immunodominant Ags of M. tuberculosis.PBMC are isolated from HLA-A2-typed TB patients and are stimulated withthe Ag-loaded, A2-based aAPC at 1:1 ratio under standard cultureconditions. Alternatively, isolated PBMC are incubated with addedpeptides for T cell stimulation by endogenous APC. At various times from4 to 120 h, cells are fixed and permeabilized and incubated withspecific probes for IL-2, IFNγ, and TNFα. Negative controls include PBMCfrom healthy, non-infected (IGRA-negative) donors stimulated with theabove-described Ag-loaded aAPC and PBMC from positive donors stimulatedwith aAPC loaded with the irrelevant melanoma-specific Mart 1 peptide(26-35 epitope) and differentiation Ag gp100 peptide (44-59 epitope).Positive controls include PBMC non-specifically stimulated with anti-CD3mAb+PHA.

b. Detection of CD4+ T Effectors.

First HLA-DRB1*04-based aAPC is constructed using the methodologydescribed above for the assembly of HLA-A*0201-based aAPC. A majoraspect of this approach is the expression of a soluble form of HLA-DR4molecules, which requires pairing of the class II a and b polypeptidesduring biosynthesis. To facilitate subunit pairing of soluble analogs ofMHC class II molecules, the IgG molecule is used as a molecularscaffold: it is divalent and can be readily modified to accommodate awide variety of protein domains. Modified a and b chains are cloned in adual promoter baculovirus expression vector. The cells infected withthis vector secrete approximately 0.5-2.0 mg/ml of the solubleHLA-DR4-Ig-like material. To assemble soluble MHC class II HLA-DR4-Igcomplexes using a generic cloning vector pZig, DNA encoding class IIextracellular domains of α and β chains of DR4 proteins is ligated toDNA encoding Ig heavy and light chains using endonuclease restrictionsites; and the chimeras are ligated sequentially to a modified pAcUW51vector. The yield, purity, and integrity of secreted proteins isconfirmed by biochemical analysis (SDS-PAGE and Western blotting) withHLA-DR4-specific mAb 0222HA (One Lambda). Purified soluble HLA-DR4-Igproteins and anti-CD28 mAb at 1:1 ratio are conjugated to magnetic beads(M-450 Epoxy Dynabeads, Dynal Invitrogen).

Known peptides derived from Rv1886c, Rv3874 and Rv3875 and restricted bythe HLA-DRB1*04 allele (Table 1) are loaded on HLA-DR4-based aAPC andused to stimulate PBMC derived from non-infected, LTBI and active TBdonors. Alternatively, isolated PBMC are incubated with added peptidesfor T cell stimulation by endogenous APC. After stimulation for varioustimes from 4 to 72 h, cells are probed for IL-2, IFNγ, and TNFα mRNA andanalyzed by FC. Negative and positive controls are as described abovefor CD8+ T cells.

TABLE 1 HLA-A*0201- and HLA-DRB1*04-restricted epitopes M. tbHLA-A2 epitope HLA-DR4 epitope protein (SEQ ID NO.) (SEQ ID NO.) Rv1886cFIYAGSLSAL (1) PVEYLQYPSPSMGRD (4) KLVANNTRL (2) LPVEYLQVPSPSMGR* (5)GLAGGAATA (3) PQQFIYAGSLSALLD* (6) Rv1986 ALGISLTV* (7)AGRLRGLFTNPGSWR (10) FLACFTLIAA* (8) VGFLACFTLIAAIGA* (11)FLIGYGLLA* (9) LDTVVLLGALANEHS* (12) Rv2220 GLLHHAPSL (13) -***SLWKDGAPL (14) Rv2659c RKAAGRPDLRV* (15) PDPYQAFVLMAAWLA* (18)KLLDNHILA* (16) TMRAHSYSLLRAIMQ* (19) FVLMAAWLA* (17)RAHYRKLLDNHILAT* (20) Rv2780 VLMGGVPGVE (21) -*** LLDSGTTSI (22) Rv3407ARVEAGEELGV* (23) AIGIRELRQHASRYL* (26) ALIESGVLIPA* (24)RLVARLIPVQAAERS* (27) RLVARLIPV* (25) KRTLSDVLNEMRDEQ* (28) Rv3874SGDLKTQIDQV* (29) IRQAGVQYSR** (30) IRQAGVQYSR** (30) EISTNIRQA (31)Rv3875 AMASTEGNV (32) FAGIEAAASAIQGNV (34) LLDEGKQSL (33)SAIQGNVTSIHSLLD* (35) *predicted using software availabe from thewebsite of Immune Epitope Datase And Analysis Resource atimmuneepitope.org. **this epitope is dually class I/II-restricted.***not needed, only used with class I-based aAPC.

The methods of statistical analysis described in Example 3 are appliedto these results. The multiple stimulation approaches in this examplealso require a mixed-model ANOVA for comparisons.

The foregoing test is able to detect both CD4+ and CD8+ effector T cellsin the blood of TB patients based on stimulation with allele-specificHLA class I- or class II-restricted peptides. Activated effector T cellsrecognizing Rv1886c, Rv3874 and Rv3875 Ags and capable of producing atleast a single cytokine, IFNγ or TNFα, are readily detectable.Co-production of two cytokines (IL-2+IFNγ+ and IL-2+ TNFα+) is lessfrequent in the terminally differentiated T cells that are the majorityof effectors in the blood of patients with active TB.

Example 5. Single T Cell Cytokine Profiles Elicited by InfectionStage-Specific Ags

PBMC from active TB, LTBI, and non-infected donors are stimulated atvarious times (4 to 120 h) with HLA-A2- and HLA-DR4-based aAPC loadedwith peptide mixtures derived from Rv1886c (active TB stage), andRv1986, Rv2659c and Rv3407 (LTBI stage). Alternatively, isolated PBMCare incubated with added peptides for T cell stimulation by endogenousAPC. The read-out is expression of IL-2, IFNγ and TNFα using three setsof about 50 singly labeled fluorescent probes and FC detection ofnumbers of expressing cells. To identify Ag candidates that maydiscriminate between disease states, one-way ANOVAs was used and agenerous p-value (p=0.25) as a cutoff. Selected Ags are used to developa model of responses that distinguishes donor groups usinggeneralizations of logistic regression such as polytomous or cumulativelogistic regression.

Stimulation with Rv1886c produces a characteristic, infectionstage-associated T-cell cytokine profile: single, double, and tripleproducers with TB patients and mostly IL-2 producers with LTBI patients.

Example 6. Identification of Functional Effector and Memory SignaturesAssociated with Infection Stage in Single T Cells

Functional markers that are inducible by TCR activation can be measuredby methods of this invention so as to accurately describe the mainfunctional T-cell subsets. For this assay candidate markers that areinducible within 4-6 hours after TCR engagement and/or genes thatreflect maturation stage and function of known T-cell subsets wereselected. The resulting panel of activation and functional markersexpressed in effector, effector memory and central memory T cells (Table2) meets these considerations. The data in Table 2 was compiled fromZinkemagel R M. T cell activation. In: Mak T W, Saunders M E, editors.New York: Elsevier; 2006. p. 373-401, and from Doherty P. T celldifferentiation and effector function. In: Mak T W, Saunders M E,editors. New York: Elsevier; 2006. p. 403-432, and references therein.

TABLE 2 Key markers defining T cell signatures* Marker Subset FunctionCD27 Naive, effector Proliferation, memory response CD40L Effector APCactivation, primary response CD44high Effector, memory Memory responseCD69high Effector, memory Activation, Th17 response CD107a CD8+effector, CTL degranulation memory CD137 Effector CTL proliferation,IFN□ production IL-2 Effector, memory Proliferation, Th1 response IFNgEffector, memory Th1 response TNFa Effector, memory Th1 response MIP-1aEffector, memory Th1 response IL-2Ra Effector, memory Proliferation CCR1Effector Homing CCR5 Effector Homing, activated memory CCR7 Centralmemory Homing, activated central memory CXCR4 Effector Homing, migrationCXCR5 CD4+ memory Homing, migration, memory LPAM-1 Effector, memoryHoming, CTL differentiation, memory VLA-4 Effector, memory Trafficking,adhesion, memory Bcl-2 Memory Anti-apoptosis, cell survival Bcl-xL CD8+memory Anti-apoptosis, cell survival Perforin CD8+ effector CytotoxicityGranzyme B CD8+ effector Cytotoxicity

The use of aAPC loaded with peptides (as in Example 3 or 4) to providestimulation via TCR and co-stimulation via CD28, or alternatively,anti-CD28 mAb combined with peptides (as in Example 3 or 4) forstimulation by endogenous APC, rapidly increases expression of keychemokines and cytokines (including but not limited to MIP-1α, IFNγ, andTNFα) and other co-stimulatory molecules (including but not limited toCD40L, CD137), which in turn further increases responsiveness. Thepositive feedback augments responses in the time frame utilized fordetection and increases the sensitivity of FC results formulti-parameter analysis. The combinations of selected markers arechosen to enable reproducible identification and characterization ofindividual effector and memory cells and their quantitative analysis inthe peripheral blood of donor groups. They serve as T-cell functionalsignatures. Four-color FC is used so that the signature(s) identifiedare suitable for analysis with instruments commonly used in clinicalsettings.

High donor reproducibility is found for data obtained with PBMCstimulated with the commercial mixture of ESAT6 and CFP10 peptides andHLA-A2- or HLA-DR4-based aAPC. The data obtained with this mixture ofpeptides are very accurate with conventional IGRA based on endogenousAPC. The robust stimulation provided by aAPC extends to induction ofmultiple targets, as described above for standard cytokine targets.Cells expressing multiple markers are also detected at higher frequencythan would be the case for conventional APC stimulation. The method ofthis example permits identification of marker sets that serve assignatures of distinct T cells that are present at different stages ofinfection, here TB infection.

Example 7. Simultaneous Detection of Two Cytokine mRNAs in StimulatedPBMC

This example shows that it is possible to detect a very small populationof fluorescent cells. Briefly, CFSE-labeled PMBC was serially dilutedinto MITOTRACKER (Invitrogen)-labeled PBMC. It was found that the assaywas able to detect the former at a frequency of 0.0013%, demonstratingsufficient sensitivity.

For demonstrating the detection of IL-2, IFNγ and TNFα mRNA, PBMCs werestimulated non-specifically via TCR with anti-CD3 mAb and PHA that isknown to induce expression of various cytokines in these cells. Afterstimulation, the cells were fixed and probed with pairwise combinationsof probe sets against IL-2 and IFNγ, IL-2 and TNFα, and also IFNγ andTNFα. One probe set in each pair was labeled with Cy5 fluorophore andthe other was labeled with TMR fluorophore. Specifically, PBMC werestimulated with anti-CD3 mAb OKT3 and PHA (both at 1 mg/ml) for 5 days,and then fixed with 4% paraformaldehyde and 70% ethanol. Fixed andwashed cells were labeled by incubating with Cy5- or TMR-labeled RNAprobes specific for IL-2 and IFNγ, washed again and analyzed bytwo-color FC (LSRII, Becton Dickinson). Results are shown in FIG. 2. Thefour plots in FIG. 2 are, from left to right, unstained/mock-hybridizedcontrol; single cytokine, IFNγ-Cy5-labeled cells; single cytokine,IFNγ-TMR-labeled cells; and double cytokine (IL-2, Cy5-labeled and IFNγ,TMR-labeled)-labeled cells. Gating shows cell populations expressing oneor two cytokines and their frequencies.

Example 8. Detection of Cytokine mRNAs in M. Tuberuclosis-Specific CellsStimulated Ex Vivo

In this example, a method according to this invention was applied forthe detection of M. tuberculosis-specific cells stimulated ex vivo.Circulating M. tuberculosis-specific cells are typically present at lowfrequencies in persons with latent TB infection (LTBI). Blood from anLTBI donor was obtained and stimulated for 5 hr with a mixture ofpeptides derived from M. tuberculosis Ag ESAT6 and CFP10 (commonly usedin T-SPOT.TB test). PBMC were incubated for 5 h either in medium aloneor with a mixture of ESAT6- and CFP10-derived peptides (T-SPOT.TB,Oxford Immunotec, UK) at 5 μg/ml. Fixed and washed cells were incubatedwith Cy5-labeled DNA probes complementary to RNA specific for GFP as anegative control, or for IL-2 and TNFα, and then analyzed by FC. Thefrequencies of cytokine producers are shown in FIG. 3, wherein the threeupper plots are for PBMC incubated in medium alone, and the three lowerplots are for PBMC incubated in medium containing the Ag mixture.

Example 9. IFNγ Detection in Co-Stimulated PBMC of LTBI Donor

PBMC were incubated for 5 h with a mixture of ESAT6- and CFP10-derivedpeptides (T-SPOT.TB, Oxford Immunotec, UK) at 5 μg/ml, with or withoutanti-CD28 mAb 53D10. Fixed and washed cells were incubated withCy5-labeled DNA probes specific for GFP mRNA (GFP, negative control)(GFP sequence refers to pTREd2EGFP (Invitrogen) or IFNγ mRNA and thenanalyzed by FC. The frequencies of cytokine producers are shown in FIG.4. Non-specific staining of control GFP was not affected by CD28co-stimulation.

Example 10. Cytokine Induction in Activated Macrophages

This example illustrates the use of artificial stimulation of non-Tcells, in this case, human macrophages obtained from peripheral blood byadherence to plastic and cultured for 2 weeks under standard conditions(RPMI 1640 media supplemented with 10% fetal bovine serum andantibiotics).

Briefly, activation was carried out with a mixture of lipopolysaccharide(LPS) (100 ng/ml) and IFNγ (20 ng/ml) orN-palmitoyl-S-[2,3-bis(palmitoyloxy)-propyl]-(R)-cysteinyl-(lysyl)3-lysine(Pam₃CSK₄) (100 ng/ml) for 4 hours or 1 day. Stimulated primarymacrophages were removed from the plastic in 0.2-0.3% EDTA in PBS, fixedand permeabilized as described in Example 7, and then incubated withFISH probes specific for IFNγ and TNFα mRNAs (Table 3) and analyzed byflow cytometry. As in Example 8, fixed and washed cells were incubatedwith Cy5-labeled DNA probes complementary to RNA specific for GFP (Table3) and analyzed by FC as a negative control. The frequencies of cellsdetected with the probes by FISH-flow analysis, described above, forinstance in example 2, are shown in FIG. 5, wherein the top row isresults with the GFP probes, the middle row is for the IFNγ probes, andthe bottom row is for the TNFα probes. The first column in each row isstimulation with LPS and IFNγ for 4 hours, the second is stimulationwith LPS and IFNγ for 1 day, the third is stimulation with Pam₃CSK₄ for4 hours, and the fourth is stimulation with Pam₃CSK₄ for 1 day.

Example 11. Expression Kinetics of Cytokine and Activation Markers inActivated T Cells

This example demonstrates identification of temporal profiles of geneexpression for cytokines, chemokines, and chemokine receptors, which aremarkers of T cell activation, in response to stimulation with PMA (25ng/ml) and ionomycin (350 ng/ml) of human T cells obtained fromperipheral blood on Ficoll gradients. More specifically, after variousperiods of stimulation (2 hours, 1 day, 3 days), cells were fixed andpermeabilized as described in Example 7, and then were either incubatedwith FISH probes specific for the indicated mRNAs (Table 3) or with mAbsrecognizing their protein products followed by flow cytometric analysis.The frequencies of cells detected with the probes by FISH-flow analysis,described above, for instance in example 2, are presented in FIG. 6A,wherein the top row is results without stimulation and the subsequentrows are results after stimulation for 2 hours, 1 day and 3 days,respectively. The first column in each row is results using GFP probes;the second column, using IL-2 probes; the third column, using IFNγprobes; the fourth column, using TNFα probes; the fifth column, usingCCL3 probes; the sixth column, using CCR7 probes, and the final column,using cFos probes. The top row is for the GFP probes, the middle row isfor the IFNγ probes, and the bottom row is for the TNFα probes. Thefrequencies of cells detected with the mAbs by FC are presented in FIG.6B, wherein the top row is results without stimulation and thesubsequent rows are results after stimulation for 2 hours, 1 day and 3days, respectively. The first column in each row is results using anegative control—isotype-matched (Iso) mAb; the second column, using mAbrecognizing IL-2; the third column, using mAb recognizing IFNγ; thefourth column, using mAb recognizing TNFα.

Example 12. Separation and Analysis of Activated Fish-Probed T Cellsinto Cytokine-Expressing and Non-Expressing Populations

This example demonstrates that the above-described FISH-Flow enableslabeling of cells that express one or multiple targets in response tostimulation, and that such responders could be isolated from the wholecellular population for the purpose of interrogating their geneexpression profiles.

Part I: Separation into Populations

Human T cells obtained from peripheral blood on Ficoll gradients andglobally stimulated with PMA (25 ng/ml) and ionomycin (350 ng/ml) for 2hours were incubated either with Cy5-labeled DNA probes complementary toRNA specific for GFP and analyzed by FC as a control or with a mixtureof several FISH probe sets (Table 3) reactive with IL-2, IFNγ, TNFα, andCCL3 mRNAs, all probes singly-labeled with Cy5. The frequencies of thecells detected with the probes by FISH-Flow analysis, described above,for instance in example 2, are presented in FIG. 7A and FIG. 7B. Resultsobtained with the GFP probes are shown in FIG. 7A. Results obtained withthe probes mixture are shown in FIG. 7B. After gating for the lymphocytepopulation based on FSC and SSC (left panel in each figure),conservative additional gating was applied to separate the analyzedlymphocytes into two distinct populations (right panel in eachfigure)—cytokine positive (denoted IFN+) and negative (denoted IFN−).The gating set up for GFP-probed cells (FIG. 7A) defined twopopulations, 0.1% IFN+ and 71.2% IFN−, out of all analyzed lymphocytes.The IL-2:IFNγ:TNFα:CCL3-probed (FIG. 7B) populations were 10.2% IFN+ and33.7% IFN− with the same gating. The latter FISH-probed cells (FIG. 7B)were separated into the positive and negative populations by FACS inorder to perform gene expression analysis on isolatedcytokine-expressing and non-expressing cells as described below. Thisapproach was also successful for stimulated T cells labeled with only anIFNγ-specific FISH probe that were distinguished and sorted into IFN+and IFN-subpopulations.

Part II: Cytokine Gene Expression Analysis of FISH-Probed and Sortedinto Activated and Non-Responding T Cell Populations.

Activated and non-responding T cells prepared and sorted into separatepopulations as described in Part I were analyzed to demonstrate distinctgene expression profiles consistent with their reactivity with specificFISH probes. Expression of mRNAs encoded by two genes, IFNγ and“housekeeping” GAPDH (control), was chosen to exemplify feasibility ofthis goal. RNA isolated from the sorted cell populations by standardmethods was subjected to RT-PCR (reverse transcription followed byamplification of the resulting cDNA by the polymerase chain reaction)using a QIAGEN OneStep RT-PCR Kit following the protocol described bythe vendor, and using primers specific to one of the two genes. Primersequences for the amplification reactions were as follows:

IFNγ forward primer: (SEQ ID NO.: 36) 5′ GAGCATCCAAAAGAGTGTGGAG IFNγreverse primer: (SEQ ID NO.: 37) 5′ TTCATGTATTGCTTTGCGTTGGGAPDH forward primer: (SEQ ID NO.: 38) 5′ CCAATATGATTCCACCCATGGCGAPDH reverse primer: (SEQ ID NO.: 39) 5′ TCCTGGAAGATGGTGATGGGATFollowing the RT incubation and initial denaturation for 15 min. at 94°C., the thermal cycling steps were: 0.5 min at 94° C., 0.5 min at 55°C., 1 min at 72° C. Forty cycles were performed. Detection of amplifiedproducts was by SYBR Green dye. Threshold cycles for the amplificationreactions are shown in FIG. 8A. To validate the amplification resultsand exclude a possibility of artifact, the size of identified ampliconswas verified with IFNγ- and GAPDH-specific primers by gelelectrophoresis. Results are shown in FIG. 8B.

TABLE 3 Probe Sequences SEQ SEQ ID ID NO NO IFNγ probes  40atcagaacaatgtgctgcac  64 tctaatagctgatcttcaga  41 ccaaaggacttaactgatct 65 tcttgtatcaagctgatcag  42 gccaaagaagttgaaatcag  66tcatcgtttccgagagaatt  43 gagctgaaaagccaagatat  67 caagagaacccaaaacgatg 44 tatgggtcctggcagtaaca  68 aaggttttctgcttctttta  45gacctgcattaaaatatttc  69 ccattatccgctacatctga  46 caaaatgcctaagaaaagag 70 cactctcctctttccaattc  47 tggctctgcattatttttct  71gtttgaagtaaaaggagaca  48 gctctggtcatctttaaagt  72 atggtctccacactcttttg 49 cttgacattcatgtcttcct  73 ctcgtttctttttgttgcta  50ttagtcagcttttcgaagtc  74 gacattcaagtcagttaccg  51 gttcatgtattgctttgcgt 75 agttcagccatcacttggat  52 ttcgcttccctgttttagct  76cgaaacagcatctgactcct  53 attactgggatgctcttcga  77 caaatattgcaggcaggaca 54 ccccatataaataatgttaa  78 cttatttgattgatgagtct  55cattacacaaaagttgctat  79 gacagtcacaggatatagga  56 cagaaaacaaaggattaagt 80 cacatagccttgcctaatta  57 ccctgagataaagccttgta  81ttaggttggctgcctagttg  58 aaacacacaacccatgggat  82 gttcattgtatcatcaagtg 59 ctggatagtatcacttcact  83 catattttcaaaccggcagt  60aagcactggctcagattgca  84 agttctgtctgacatgccat  61 tcagggtcacctgacacatt 85 ctcctgagatgctatgtttt  62 ttggaagcaccaggcatgaa  86cagtcacagttgtcaacaat  63 tgagttactttccatttggg  87 gtgaacttacactttattcaIL-2 Probes  88 tagcccacacttaggtgata 112 gtgaaatccctctttgttac  89agactgactgaatggatgta 113 ggaatttctttaaaccccca  90 ttcctcttctgatgactctt114 gaaaaaacattaccttcatt  91 tttcaaagactttacctgtc 115tgttttacatattacacata  92 aatattatgggggtgtcaaa 116 ttatactgttaattctggaa 93 ctcttgaacaagagatgcaa 117 attaaagagagtgataggga  94ttgaggttactgtgagtagt 118 tcctgtacattgtggcagga  95 caatgcaagacaggagttgc119 tgacaagtgcaagacttagt  96 ttgaagtaggtgcactgttt 120gctgtgttttctttgtagaa  97 gcagtaaatgctccagttgt 121 tcaaaatcatctgtaaatcc 98 tcttgtaattattaattcca 122 gcatcctggtgagtttggga  99gcatgtaaaacttaaatgtg 123 tcagttctgtggccttcttg 100 cttctagacactgaagatgt124 cctccagaggtttgagttct 101 tttgagctaaatttagcact 125gtcttaagtgaaagtttttg 102 tattgctgattaagtccctg 126 gttccagaactattacgttg103 atgttgtttcagatcccttt 127 catcagcatattcacacatg 104attctacaatggttgctgtc 128 aggtaatccatctgttcaga 105 gttgagatgatgctttgaca129 gcacttaattatcaagtcag 106 ctgatatgttttaagtggga 130atatttaaataaatagaagg 107 caacaataaatataaaattt 131 ataggtagcaaaccatacat108 agattaagaataatagttac 132 agatccatatttatagtttt 109gggcttacaaaaagaatcat 133 gaaaccattttagagcccct 110 aatattttgggataaataag134 ctatatttaacattcaacat 111 actaaccaatctacatagat 135tcaaatttattaaatagttt TNFα probes 136 tcctctgctgtccttgctga 160agttgcttctctccctctta 137 tctgagggttgttttcaggg 161 atgtgagaggaagagaacct138 tgtcctttccaggggagaga 162 gatcatgctttcagtgctca 139aagaggctgaggaacaagca 163 aaagtgcagcaggcagaaga 140 tgattagagagaggtccctg164 agaagatgatctgactgcct 141 tgggctacaggcttgtcact 165agcttgagggtttgctacaa 142 tggttatctctcagctccac 166 tgaggtacaggccctctgat143 ttgaagaggacctgggagta 167 ttgaccttggtctggtagga 144gctcttgatggcagagagga 168 agatagatgggctcatacca 145 acccttctccagctggaaga169 attgatctcagcgctgagtc 146 tcggcaaagtcgagatagtc 170atgatcccaaagtagacctg 147 tttgggaaggttggatgttc 171 taataaagggattggggcag148 agaggttgagggtgtctgaa 172 cccaattctctttttgagcc 149ttctaagcttgggttccgac 173 gtggtggtcttgttgcttaa 150 attcctgaatcccaggtttc174 tagtggttgccagcacttca 151 tggaggccccagtttgaatt 175aaagctgtaggccccagtga 152 tctccagattccagatgtca 176 attctggccagaaccaaagg153 taggtgaggtcttctcaagt 177 ctaaggtccacttgtgtcaa 154aaacatctggagagaggaag 178 tccgtgtctcaaggaagtct 155 ataaatagagggagctggct179 ccggtctcccaaataaatac 156 acattgggtcccccaggata 180aaaacatgtctgagccaagg 157 ttgttcagctccgttttcac 181 atcaaaagaaggcacagagg158 ggtcaccaaatcagcattgt 182 aggctcagcaatgagtgaca 159attacagacacaactcccct 183 ttctcgccactgaatagtag ACSL1 probes 184tgcaatgtgatgcctttgac 208 gaaggccattgtcgatagaa 185 ttcgccttcattgttggagt209 tgaaatagttccgcagctct 186 tagaggtcatctatctgcga 210acactaaaccttgatagtgg 187 ccatttcctctgagctttct 211 gagaagagattgtggaactg188 aacaacatgaaggccatcag 212 ccctacacttgctgtattca 189aagtcaaacacgaacgcttc 213 tatgagaagaaccccgaatg 190 gtgttctctttcctctagca214 aacatgaggtgactgtaagg 191 ggctcattttggaaagtgtg 215gcacatttatagtatcccct 192 ctgaggaagtctcaaataac 216 gaaacagggagacagaagat193 caaagtcctaaccccttgat 217 gtagcagacatctcagagat 194agacagctgcagaatttgca 218 gcactgtactctttagagca 195 aaagggaacacttccctcta219 gccaggacagttgttcttat 196 tggtccgcttgtgagattct 220ggacagtagcagggatttaa 197 ttctgtgaatgcctgtgaga 221 cgtaacccttacgaatcaga198 gactggagaagaacatgagt 222 atgctccaacagaaaccaca 199atggttctgagttggatctg 223 atttgccagaggctccttat 200 aatccacgcgttctgatgag224 agagcattctgccatgaaag 201 aacccctgaaaaaggatgga 225cactatagaatctaaggcag 202 ctgatccaggtaactctttc 226 acagttattcaggcgtcaca203 gtgagtggttcagtgaagat 227 ggcaagttaatcccaacatg 204gaaatgcttgcctgagagtt 228 gtactcaagtatatactccc 205 ccaggaaatgaactttccag229 caaatgtggcaaagactcac 206 ccccaaaacagctgctttaa 230gccctgttgtgcttgtatat 207 gttaggctaccaagtagtgt 231 caaaaccccaaggtgacaaaCCL3 probes 232 ctgctgcccgtgtcctt 252 agaaaggactgaccact 233ctcgagtgtcagcagag 253 gagcaggtgacggaatg 234 agtggagacctgcatga 254gaggacagcaagggcag 235 gagagccatggtgcaga 255 tgcagagaactggttgc 236cgtgtcagcagcaagtg 256 gtagctgaagcagcagg 237 gtggaatctgccgggag 257agtcagctatgaaattc 238 ggctgctcgtctcaaag 258 caccgggcttggagcac 239gcttggttaggaagatg 259 cacagacctgccggctt 240 cactcctcactggggtc 260cgctgacatatttctgg 241 ctcaggcactcagetec 261 ctcgaagcttctggacc 242ccaccgaggtcgctggg 262 tcaggctcctgctcctc 243 acacgcatgttcccaag 263aagaggtagctgtggag 244 gcaacaaccagtccata 264 ccacagtgtggctgttt 245tttaagttaagaagagt 265 agtataaataaattaaa 246 aaattacaaaaactaaa 266acacactctgaaatcga 247 cagagcaaacaatcaca 267 aggggacaggggaactc 248gttgtcaccagacgcgg 268 gctgatgacagccactc 249 gccatgactgcctacac 269tcagtctggtggctttg 250 gcatccgatacacattt 270 tcacagccctgaacaaa 251attatttccccaggccg 271 accttttaaaagagcat CCR7 probes 272cggtaaaaccacacagga 296 caggtccatgacgctctc 273 cagcacgcttttcattgg 297aatgacaaggagagccac 274 ttgacacaggcatacctg 298 tgtaatcgtccgtgacct 275ccactgtggtgttgtctc 299 aagactcgaacaaagtgt 276 cgcacgtccttcttggag 300ggaggaaccaggctttaa 277 acaaatgatggagtacat 301 attgcccagtaggcccac 278ataggtcaacacgaccag 302 tggtcttgagcctcttga 279 ttgagcaggtaggtatcg 303tgtaggcccagaagggaa 280 cgaagacccaggacttgg 304 tgagcttgcaaaagtgga 281gctcatcttgtagatggc 305 taggagcatgccactgaa 282 gtcaatgctgatgcaaag 306ctggacgatggccacgta 283 ggacagcttgctgatgag 307 gcactgtggctagtatcc 284tacaggagctctgggatg 308 ctgctcctctggaggtca 285 agagcatcgcatcgcttg 309ctccacatgctctgtgat 286 ccacctggatggtgataa 310 cagaaagccgatcaccat 287gaagctcatggccagcag 311 gcggatgatgacaaggta 288 ctcaaagttgcgtgcctg 312atcaccttgatggccttg 289 atgaagaccacgaccaca 313 attgtagggcagctggaa 290cgtctgggccaggaccac 314 gctactggtgatgttgaa 291 ttgcttactgagctcaca 315gacgtcgtaggcgatgtt 292 gacgcaggccaggctgta 316 gaaagggttgacgcagca 293gacgccgatgaaggcgta 317 gaagagatcgttgcggaa 294 gcccaggtccttgaagag 318gagctgctcctggctgag 295 gatgtgccgacaggaaga 319 ctccacactcatggaggacFos probes 320 tctgcaaagcagacttctca 344 tctgcaaagcagacttctca 321ttcagcaggttggcaatctc 345 actctagtttttccttctcc 322 tcggtgagctgccaggatga346 aggtcatcagggatcttgca 323 agacatctcttctgggaagc 347agtcagatcaagggaagcca 324 tgaaggcctcctcagactcc 348 agggtcattgaggagaggca325 acaggttccactgagggctt 349 tccatgctgctgatgctctt 326atcaaagggctcggtcttca 350 tgatgctgggaacaggaagt 327 tcagagccactgggcctgga351 tcagagccactgggcctgga 328 tgctgcatagaaggacccag 352actgtgcagaggctcccagt 329 tctgtggccatgggccccat 353 tacaggtgaccaccggagtg330 tgtaagcagtgcagctggga 354 taggtgaagacgaaggaaga 331acagctggggaaggagtcag 355 tcattgctgctgctgccctt 332 agctgagcgagtcagaggaa356 agtggcacttgtgggtgccg 333 tgtaatgcaccagctcgggc 357gaagatgtgtttctcctctc 334 gtctacaggaaccctctagg 358 acagataaggtcctccctag335 acagcctggtgtgtttcacg 359 ctttcaagtccttgaggccc 336cttgagtccacacatggatg 360 atctccggaagaggtaagga 337 cactccatgcgttttgctac361 gtgtcactgggaacaataca 338 ctaactaccagctctctgaa 362aggcctggctcaacatgcta 339 agagaaaagagacacagacc 363 tatgagaagactaaggaga340 cccaatagattagttaatgc 364 ccaggttaattccaataatg 341caatttgaaaatatccagca 365 gttaaaatcagctgcactag 342 ccaggaacacagtagttatt366 ctaatcagaacacactattg 343 cttagtataatattggtcat 367ccagaaaataaagtcgtatc GFP probes 368 tcgcccttgctcaccat 392accccggtgaacagctc 369 tcgaccaggatgggcac 393 ttacgtcgccgtccagc 370gctgaacttgtggccgt 394 tcgccctcgccggacac 371 cgtaggtggcatcgccc 395cttcagggtcagcttgc 372 ccggtggtgcagatgaa 396 agggcacgggcagcttg 373agggtggtcacgagggt 397 actgcacgccgtaggtc 374 tcggggtagcggctgaa 398cgtgctgcttcatgtgg 375 ggcggacttgaagaagt 399 acgtagccttcgggcat 376agatggtgcgctcctgg 400 gccgtcgtccttgaaga 377 gcgcgggtcttgtagtt 401cctcgaacttcacctcg 378 gttcaccagggtgtcgc 402 cccttcagctcgatgcg 379cctccttgaagtcgatg 403 ccccaggatgttgccgt 380 ttgtactccagcttgtg 404cgttgtggctgttgtag 381 gtcggccatgatataga 405 atgccgttcttctgctt 382tcttgaagttcaccttg 406 ctcgatgttgtggcgga 383 agctgcacgctgccgtc 407tgctggtagtggtcggc 384 tcgccgatgggggtgtt 408 ttgtcgggcagcagcac 385gggtgctcaggtagtgg 409 tttgctcagggcggact 386 cgcttctcgttggggtc 410gcaggaccatgtgatcg 387 ggcggtcacgaactcca 411 atgccgagagtgatccc 388tcttgtacagctcgtcc 412 gaagccatggctaagct 389 tcctgctcctccacctc 413tgggcagcgtgccatca 390 ctcctgggcacaagaca 414 tgacggtccatcccgct 391agaagcacaggctgcag 415 tacacattgatcctagc HIV Gag RNA probes 416ttaatactgacgctctcgca 440 catttatctaactctccccc 417 ccctggtcttaaccgaattt441 ctgcttgcccatactatatg 418 aactgcgaatcgttctagct 442atgtttctaacaggccagga 419 ccagtatttgtctacagcct 443 tgtctgaagggatggttgta420 gagggtggctactgtattat 444 ctatcctttgatgcacacaa 421gcttccttggtgtcttttac 445 gctcttcctctatcttctct 422 gctgtgcctttttcttactt446 tttttcctgtgtcagctgct 423 gtaattttggctgacctggt 447cctggatgttctgcactata 424 atggcctgatgtaccatttg 448 ctgaaagccttctcttctac425 gctccttctgataatgctga 449 ggtgtttaaatcttgtgggg 426tttgcatggctgcttgatgt 450 cttcctcattgatggtctct 427 tgcaatctatcccattctgc451 tcatctggcctggtgcaata 428 tatgtcacttccccttggtt 452gaagggtactagtagttcct 429 gtcatccatcctatttgttc 453 ctactgggataggtggatta430 cccaggattatccatctttt 454 gtagggctatacatccttac 431gtccttgtcttatgtccaga 455 catagtctctaaagggttcc 432 agagttttatagaaccggtc456 tttacctcctgtgaagcttg 433 caacaaggtttctgtcatcc 457aatctgggttcgcattttgg 434 gctggtcccaatgcttttaa 458 ggcatgctgtcatcatttct435 aaactcttgctttatggccg 459 tacttggctcattgcttcag 436ctgcatcattatggtagctg 460 cccttctttgccacaattga 437 ggctctgcaatttttggcta461 tccaacagccctttttccta 438 tttggtgtccttcctttcca 462cctgtctctcagtacaatct 439 gggccagattttccctaaaa 463 aagaaaattccctggccttc

The foregoing examples and description of the preferred embodimentsshould be taken as illustrating, rather than as limiting the presentinvention as defined by the claims. As will be readily appreciated,numerous variations and combinations of the features set forth above canbe utilized without departing from the present invention as set forth inthe claims. Such variations are not regarded as a departure from thescope of the invention, and all such variations are intended to beincluded within the scope of the following claims. All references citedherein are incorporated herein in their entireties.

What is claimed is:
 1. A method for detecting copies of at least one RNAexpressed in individual mammalian cells, comprising (a) providing asample containing a population of mammalian cells; (b) inducing geneexpression in the mammalian cells ex vivo, either immediately or afterculturing, by incubating the mammalian cells with at least one antigenthat will bind specific receptors of the mammalian cells and initiategene expression; (c) fixing and permeabilizing the mammalian cells; (d)labeling copies of a first target RNA expressed by the mammalian cellswith a first set of 10-100 fluorescently labeled oligonucleotidehybridization probes each singly labeled with the same fluorescentmoiety, and washing away unbound probes, wherein the first set of probesbind simultaneously to said first target RNA; and (e) detecting cellshaving expression events using flow cytometry (FC), an expression eventbeing one or more fluorescence measurements of bound fluorescentlylabeled oligonucleotide hybridization probes categorized by fluorescenceintensity gating, wherein the step of inducing comprises stimulatingT-cell receptor (TCR) signaling and down-stream gene expression byantigen presenting cells (APCs) that are present in the cell populationor by an artificial APC (aAPC).
 2. The method of claim 1 whereinstimulation by APC or aAPC induction is for a period selected from thegroup consisting of from 30 minutes to 6 hours, from 6 to 24 hours, andfrom 24 to 72 hours.
 3. The method of claim 1 wherein the step ofinducing includes co-stimulating with at least one monoclonal antibody(mAb).
 4. The method of claim 1, wherein the step of inducing includesco-stimulating with at least one monoclonal antibody (mAb) that is boundto the aAPC.
 5. The method of claim 1 wherein the antigen is derivedfrom a microorganism.
 6. The method of claim 1 wherein the antigencomprises a peptide or mixture of peptides.
 7. The method of claim 1wherein a peptide or mixture of peptides that associate with MHC class Ior MHC class II molecules is added to the APC or aAPC.
 8. The method ofclaim 7, wherein the peptide or peptide mixture is present at aconcentration between 1-20 μg/ml.
 9. The method of claim 1 wherein theat least one RNA is encoded by a cytokine gene.
 10. The method of claim9 wherein the gene encodes IL-2, TNFα, or IFNγ.
 11. The method of claim1 wherein the antigen is a M. tuberculosis-derived immunogenic peptide.12. The method of claim 1 wherein the probe set comprises 20-60 probesthat bind simultaneously to the at least one RNA molecule.
 13. Themethod of claim 1 wherein the cell population comprises T cells obtainedfrom human PBMCs, the at least one RNA molecule is encoded by a cytokinegene, cells in the cell population are induced by aAPC with one or morepeptide-loaded MHC molecules that interact with TCR, and the probe setcomprises 20-60 probes.
 14. The method of claim 1, wherein at least onedetected cell having expression events is separated from cells nothaving expression events by fluorescence-activated cell sorting.
 15. Themethod of claim 14, wherein gene expression is measured in the separatedcells.
 16. The method of claim 15, wherein measurement of geneexpression is accomplished by RT-PCR or a transcriptomic analysis of RNAin the cells.
 17. The method of claim 1 wherein the step of inducingcomprises stimulating toll-like receptor signaling and down-stream geneexpression with a microbial product or a synthetic compound, wherein themicrobial product is a lipid, glycan, glycolipid, sulfolipid,glycoprotein, protein, peptide, or nucleic acid and wherein the stimulusis present at a concentration between 1-100 ng/ml, 100-1000 ng/ml, or1-20 μg/ml.
 18. The method of claim 17, wherein stimulation is for aperiod selected from the group consisting of from 30 minutes to 6 hours,from 6 to 24 hours, and from 24 to 72 hours.
 19. The method of claim 1,wherein the antigen is a cytokine.
 20. The method of claim 19, whereinthe cytokine is one selected from the group consisting of IFNγ, IL-2,IL-15 and TNFα.
 21. The method of claim 1 wherein more than one antigenor stimulus is provided.
 22. The method of claim 21 wherein differentstimuli are provided at different times.
 23. The method of claim 1,wherein the receptors are selected from the group consisting oftoll-like receptors, NOD and NOD-Like receptors, G protein coupledreceptors, polypeptide hormone receptors, cytokine receptors, B cellreceptors, and T cell receptors.
 24. The method of claim 1, wherein thepopulation comprises cells selected from the group consisting of PBMCs,T-cells, lymphocytes, CD3⁺CD4⁺ T cells (T helper 1 or Th1 cells),CD3⁺CD4⁺ T cells (T helper 2 or Th2 cells), CD3⁺CD8⁺ T cells, Th17, Tregcells, NK cells, NKT cells, macrophages, dendritic cells, cells ofendothelia and epithelia of various body organs, and cells of thenervous system.
 25. The method of claim 1, wherein the probes are 15-25nucleotides long.
 26. The method of claim 1, further comprising labelingcopies of a second target RNA expressed by the mammalian cells with asecond set of fluorescently labeled oligonucleotide hybridization probeseach singly labeled with a same second fluorescent moiety that isdifferent from the first fluorescent moiety, and washing away unboundprobes, wherein the second set of probes bind simultaneously to saidsecond target RNA, said second target RNA being different from saidfirst target RNA.
 27. The method of claim 26, further comprisinglabeling copies of a third target RNA expressed by the mammalian cellswith a third set of fluorescently labeled oligonucleotide hybridizationprobes each singly labeled with a same third fluorescent moiety that isdifferent from the first fluorescent moiety and the second fluorescentmoiety, and washing away unbound probes, wherein the third set of probesbind simultaneously to said third target RNA, said third target RNAbeing different from said first target RNA and said second target RNA.28. A method for detecting copies of at least one RNA molecule expressedin individual mammalian cells, comprising (a) providing a samplecontaining a population of mammalian cells; (b) fixing andpermeabilizing the mammalian cells; (c) labeling copies of a firsttarget RNA expressed by the mammalian cells with a first set of 10-100fluorescently labeled oligonucleotide hybridization probes each singlylabeled with the same fluorescent moiety, and washing away unboundprobes, wherein the first set of probes bind simultaneously to saidfirst target RNA; and (d) detecting cells having expression events usingFC, an expression event being one or more fluorescence measurements ofbound fluorescently labeled oligonucleotide hybridization probescategorized by fluorescence intensity gating.
 29. A method for analysisof gene expression in mammalian cells present in a population comprisingT cells by detecting copies of at least one RNA expressed in individualmammalian cells, comprising (a) providing a sample containing apopulation of mammalian cells comprising T-cells; (b) inducing geneexpression in the mammalian cells ex vivo, either immediately or afterculturing, by incubating the mammalian cells with at least one compoundthat will bind specific receptors of the mammalian cells and initiategene expression; (c) fixing and permeabilizing the mammalian cells; (d)labeling copies of a first target RNA expressed by the mammalian cellswith a first set of fluorescently labeled oligonucleotide hybridizationprobes each singly labeled with the same fluorescent moiety, and washingaway unbound probes, wherein the first set of probes bind simultaneouslyto said first target RNA; and (e) detecting cells having expressionevents using FC, an expression event being one or more fluorescencemeasurements of bound fluorescently labeled oligonucleotidehybridization probes categorized by fluorescence intensity gating,wherein the step of inducing comprises stimulating T-cell receptorsignaling and down-stream gene expression by antigen presenting cellsthat are present in the cell population or by an artificial APC.
 30. Themethod of claim 29, wherein the population comprises cells selected fromthe group consisting of PBMCs, T-cells, lymphocytes, CD3⁺CD4⁺ T cells (Thelper 1 or Th1 cells), CD3⁺CD4⁺ T cells (T helper 2 or Th2 cells),CD3⁺CD8⁺ T cells, Th17, Treg cells, NK cells, NKT cells, macrophages,dendritic cells, cells of endothelia and epithelia of various bodyorgans, and cells of the nervous system.